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APHA Scientific Session and Event Listing

Recorded presentation

Stephanie Chalupka, EdD, APRN¹, Pia K. Markkanen, ScD², Deborah Chaulk, MSc¹, Letitia Davis, ScD³, Natalia Firsova, MA³, Catherine Galligan, MSc², Angela K. Laramie, MPH³, and Margaret M. Quinn, ScD, CIH². (1) Department of Nursing, School of Health and Environment, University of Massachusetts Lowell, 3 Solomont Way, Lowell, MA 01854, 978-934-4430, Stephanie_Chalupka@uml.edu, (2) Department of Work Environment, School of Health and Environment, University of Massachusetts Lowell, One University Avenue, Lowell, MA 01854, (3) Occupational Health Surveillance Program, Massachusetts Department of Public Health, 250 Washington Street, 6th floor, Boston, MA 02108

Home health care (HHC) is one of the fastest growing industries in the U.S., yet little research has been conducted to evaluate hazards and working conditions of HHC nurses and other providers. This paper presents qualitative research findings on preventing blood exposures and injuries from sharp medical devices (sharps) among HHC providers. The overall research objective was to characterize the work experience and working conditions of HHC providers. Five focus groups and 10 in-depth interviews were conducted among HHC nurses and aides at 2 large private agencies and 2 HHC provider unions. Results provided a rich understanding of many dimensions of HHC work. Examples of commonly reported hazards included: unsanitary and unpredictable worksites, time pressures to maintain high productivity levels, mentally unstable and violent patients and family members, guns in homes, illegal drug activity on neighborhood streets. Blood exposures and sharps injuries were particularly associated with care of diabetic and cancer patients, lack of proper workstations, the lack of, or poorly designed medical safety devices, and unsafe sharps disposal containers. Use of sharp safety devices was variable, and several institutional barriers to universal application were identified. Despite the challenges, most HHC nurses found their work profoundly meaningful, citing rewarding relationships with patients and their families, independent work organization (compared to hospitals), and feedback from patients and families of their positive impacts on people's lives. Participants identified various intervention possibilities to improve blood-borne pathogens safety that compromise neither the quality of patient care nor satisfying HHC job aspects.

Learning Objectives:

• Understand blood exposure and sharps injury risks for home healthcare providers.
• Identify challenges and opportunities for reducing occupational health risks and improving the quality of home healthcare providers work lives.

Keywords: Home Care, Infectious Diseases

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation